The evolution of our understanding on glioma

Abstract

The description of neuroglia by Virchow in 1848 may be considered the starting point of our understanding of primary brain tumors. At the beginning of the 20th century, surgical removal of primary brain tumors became possible, and therefore, tissue for microscopic analysis and clinical data on survival became available. During this time, research on gliomas beyond improving surgical procedures focused on their classification. The classification schemes developed emphasized parameters for sorting tumors with regard to (i) cytological aspects; (ii) presumed tumor cell origin; (iii) histological appearance of the tissue; or (iv) clinical outcome. Over the years, experimental studies have greatly improved our knowledge on gliomas. Gliomas induced by viruses, chemicals, radiation, transgenes and knock-out technology contributed to the understanding of their pathogenesis and still serve as preclinical models for the testing of novel therapies. Recent advances in developmental neurobiology and the identification of stem cells provided new insights into the origin of brain tumors and the molecular mechanisms of tumor formation. This review briefly compiles the evolution of our concepts on gliomas, focusing on the latest developments.

Figure 1

Classification scheme of primary brain tumors by Bailey and Cushing. Tumors were expected to arise from cells with corresponding differentiation. For example, medulloepithelioma would originate from the medullary epithelium or oligodendroglioma would originate from oligodendroglia (adapted from Bailey P (1948) Intracranial Tumors, 2nd ed. Thomas: Springfield, IL).

Figure 2

A. Neurocytic rosettes and perivascular pseudorosettes in rosette‐forming glioneuronal tumor of the fourth ventricle; HE × 100. B. Binding of antibodies to synaptophysin (SYN) in the neuropil lining delicate vessels in the perivascular pseudorosettes; SYN × 400.